Study: Medicaid expansion cuts down uninsured surgical hospitalizations

Medicaid expansion is associated with a reduction in surgical hospitalizations among the uninsured, a new study shows.

Research published in Health Affairs examined state-level data across 44 states and patient-level data across four states to compare such hospitalizations in expansion and non-expansion states.

Patients admitted for surgery largely first presented to the emergency department, and in 99% of cases their care would likely result in catastrophic visit costs, according to the study. In states that expanded Medicaid, the rate of uninsured discharges for these surgeries was lower, at 7.85 per 100,000.

"Uninsured patients undergoing surgery are at extremely high risk for associated charges that amount to a catastrophic financial burden," the researchers wrote.

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Medicaid expansion was also linked to a 6.2% reduction in the share of such hospitalizations.

The researchers said that studies like this one have implications for states where conversations are brewing about expanding Medicaid. In 2019 alone, nonexpansion states could have prevented more than 50,000 cases of catastrophic financial burden had they expanded Medicaid.

Getting expansion holdouts to sign on is a priority for the Biden administration. Twelve states have not expanded the program under the Affordable Care Act, and Missouri has adopted expansion through a ballot measure but has not rolled it out amid a legal back-and-forth.

"Medicaid expansion represents a large opportunity to reduce the risk for uninsured surgeries and the associated catastrophic financial burden," the researchers said.